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Exploratory mixed methods study of respiratory physiotherapy for patients with lower respiratory tract infections
1Lab 3R - Respiratory Rehabilitation & Research, School of Health Sciences (ESSUA), University of Aveiro, Aveiro, Portugal.
Objectives:
To assess the outcomes of respiratory physiotherapy for patients with lower respiratory tract infections (LRTI).
Design:
Parallel group mixed-methods study.
Setting:
Patients were recruited from a general hospital. Respiratory physiotherapy took place in a community setting.
Participants:
Fifty-four patients aged ≥18 years and diagnosed with LRTI completed the study. Twenty-seven patients were allocated to the control group {CG: 10 male, mean age 53.3 [standard deviation (SD) 17.4] years} and 27 patients were allocated to the experimental group [EG: 10 male, mean age 58.6 (SD 17.2) years].
Intervention:
The CG received conventional medical treatment and the EG received conventional medical treatment plus respiratory physiotherapy for 3 weeks.
Outcome Measures:
Patients in both groups undertook the 6-minute walk test (6MWT), modified Borg scale (MBS), modified Medical Research Council questionnaire (mMRC), and Breathlessness, Cough and Sputum scale (BCSS) before and after the intervention. A telephone follow-up survey was performed 3 months after the first hospital visit. Interviews were conducted immediately after the intervention in the EG.
Results:
In the EG, the distance walked in the 6MWT increased by more than the minimally important difference (P=0.001), and significantly more than the CG {EG: mean change 76m [standard deviation (SD) 63], 95% confidence interval (CI) 51 to 101; CG: mean change 27m (SD 56), 95% CI 5 to 49; mean difference between groups: 49m 95% CI 16 to 82; partial η(2)=0.15}. No differences in the MBS, mMRC and BCSS were found between the two groups. The EG reported high levels of satisfaction with the intervention (27/27; 100%) and with the physiotherapist (20/27; 74%). The intervention improved patients' symptoms (19/27; 70%) and their self-management skills to control/prevent future LRTI (19/27; 70%). Health service use was significantly less in the EG (P=0.04).
Conclusions:
Respiratory physiotherapy appears to be effective for the management of patients with LRTI. CLINICALTRIAL.
Gov Registration Number:
NCT02053870.
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